Laserfiche WebLink
r <br />r <br />"""" APPLICATION FOR PUBLlC WORKS PERMIT <br />l�J <br />PUBLiC WORKS <br />TyDa or prinl tlrarly wllh Ink �� �� <br />PRESS HARD • YQU ARE MAKING COPIES pERM1T NO. <br />EVERETT, WASHINGTON / � BLDG. DEPT. NO. 8� ' S�O <br />1$ OWNEZ ❑ AGENT DATE � _� �. _�I - <br />APPLICANT/FIRM REPRESENTED !�CL'ZLLI� --1 L� � l _���rCl <br />ADDRESS ��0�"� " ��� �� CITY � Pr�' —TELEPHONE 3 5 S ",� � U <br />HEREBY APPUES FOR PERMISSION TO ��/ �� r�s� C/C' ��J� �C� <br />A7 .' IE FOI.LOWING LOCATION �C� �' ���a S 5 d(j 5 <br />Attach five (5) copies of preliminary plans for proposed work. Draw to scale and show the following as appiicable: <br />• Property lines and street identity. <br />• Outline and dimensions of existing and <br />proposed structures. <br />• Existing and proposed utilitias. <br />• Centerline of abutting right of way. <br />CONDITIONS: . . . <br />I . I.: er��tinc: clr��ewa .n�H�t bo <br />, : : : � : -F�+i� 1����,.5- e..��� S„Ne. <br />. . . . . . uf�lat) � . . <br />• Topographic changes requiring cu!s and fills <br />other than normal foundation. <br />• site drainage systems when required. <br />Ero ion control methods when required. <br />• No h arroyq �� /1 <br />�i].l�l� <br />-i�f-11r.II�I rrn�o��.�r a.. �� �r�Pla1��n �..,;1�, <br />nH�.J tP��tlar s �<�P..,nl%_ '�O �+^�� c«iJaN� . <br />.__ � eZ.. ��w cf1'�'aPway �6.��� 6� i�sia/1.�����e�� Li�'J s�cis. 7�e rr.s1�»� <br />� .l� s�.MIL ...Ns� br 1 / I r� <br />_. . . . . . .CNry d�.T�N�, A!' .•�J�i�l{� ifnra� �AJCF%nS A.fT. . <br />/ n , /' �� <br />._. . . . . � o� �� �,o i CN��a /J. �cf .���oa�rcl�- Cwr�J owJ� fyF+%. mws� /�� '�l�'..�i�J . <br />//� / <br />. , . /CM�✓��, �Pmi,�✓.r�3:. i+��isf br .tia�� �v nnr�� G'?fQ9n�_�io!f. . <br />. . :�` � ' Joi�T n/ svw-!'�.�.'�' ai nPari�/- scui� �n�ir�, - � <br />''` <br />_ � ' . '____--_i_� ' . . � . . . <br />� � � ' T�e unEarsigned owner hareby agroes to hold entl save hermleea <br />� -' ' ' . ' ' ' � � � � � . , � � . Ihn Cily ol Euere�l trom eny ena an c�aime lor dameqo0. coet0. <br />�'''' � � expenses, or cauaes ol ection t�at mey erlea hecause ol Ine1�IlHlon <br />f: _ _ : . . , , . . . . . . . . . . and maintenance ol I�e improveme�t or ol�er ripM�oFw�y uee <br />. �ereto ap0��ed Icr anA lurther epreea lo iemove neme upon nolke <br />� . , � � Irom ine Ci1y and to replaca punlic oroperly dam�Qaf thareby. <br />�� �-a-a3 <br />L APPROVED FOR CONSTRU�i /N DATE <br />u���is �� <br />V D AS CONSTRUCTED DATE <br />PERMIT IS VALID FOR 1 YEAR <br />1� EXPIRATIUN <br />POST ON <br />JOBSITE <br />OF <br />� <br />�3 <br />CALL FOR IN$�PECTION <br />259-8811 <br />24 HRS. BEFORE CONSTRUCTION <br />1 <br />� <br />J <br />� <br />J <br />